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This piece includes spoilers for the Netflix show To the Bone

‘In reality, the disorder can be dull, painful, and achingly, achingly embarrassing’

The emotional climax of Netflix’s new anorexia drama To The Bone takes place on a mountain top. It is – I imagine – a metaphor. The film’s protagonist Ellen (Lily Collins) has dragged her painfully thin body through dusty, rocky terrain to die. Yet she lives. With chapped lips and burnt skin she awakes from her near-death experience and climbs back down. We know that an eccentric British boy will be waiting for her. They’re in love.

Since the official trailer was released on 20 June, To The Bone has been criticised for encouraging anorexia. In fairness to the film, it is hard not to – as even the most distressing displays of disordered eating can become aspirational to sufferers. Ellen’s bruises from her sit ups, her protruding ribs, and her fainting in public places can – and already have – become “thinspiration” for anorexics.

But for me, a former sufferer, the film’s greatest sin isn’t glamorising anorexia. It’s dramatising it.

There is no picturesque drama

The only way to make a good film about anorexia would be to make a bad one. The disorder doesn’t fit neatly within the constraints of a 107-minute run time, and there aren’t clear-cut climaxes and crescendos on mountain tops. In a realistic anorexia film, the finale would take place in a bedroom. For that matter, so would the beginning – and a lot of the middle too. In To The Bone, dramatic scenes are broken up by shots of Ellen being weighed. For most anorexics, these scenes wouldn’t divide the action – they would be it.

There are no inevitabilities in anorexia, yet our media repeatedly paints the same picture of sufferers. In magazines and movies, anorexia is presented at its most extreme and romantic. In reality, the disorder can be dull, painful, and achingly, achingly embarrassing.

If my anorexia were a movie, the emotional climax wouldn’t be an unconventional doctor taking me to dance in the rain or a boy telling me he loves me whether I like it or not – it would be my mum calling out a plumber to find out why the toilet’s blocked. It would be that plumber diving into the u-bend to pull out a Marks & Spencer cheese scone that my mum had begged me to eat and I had flushed down the loo.

‘Movies live and die on human relationships – anorexia doesn’t‘

Antisocial and lonely

In my experience (though I would emphasise that no experience is universal) anorexia was inherently antisocial. When Ellen’s love interest tries to coax her into eating chocolate midway through the movie and she gets angry at him, he promises to try again.

In reality, anorexia forces you to hurt the ones you love the most – urging you to say increasingly horrible and bitter things to drive people away. Movies live and die on human relationships – anorexia doesn’t. The disease forces you to avoid parties, people, and places where food will be. As a teen, I started avoiding the girl I had walked to school with for years – hurting her in the process. Why? Because every morning my schoolbag hid last night’s dinner wrapped up in a carrier bag, and I needed to find a public bin to throw it in before it started to stink. In one of the movie’s ostensibly uplifting scenes, Ellen changes her name to “Eli”. She is lucky she had anyone left to call her it.

Pain of embarrassment

Even the moments of pain in To The Bone are dramatic in romantic ways. The real pain of anorexia isn’t the aching of your body as you force it to jog – it’s the torment of your teacher mocking you in front of the entire class for “always running”. In just about the only realistically gross moment of the film, Ellen discovers her roommate’s “barf stash” – a box of vomit she has been hiding from the nurses. But you don’t see anything, and no one is humiliated. The reveal takes place via black-lined eye rolls and an edgy conversation. The only thing sharper than Ellen’s cheekbones is her wit.

And anorexia is gross. It’s bad breath, hair loss, and chewing and spitting out your food. The last of these is the one the movie chooses to portray – but the scene is set in a restaurant, and Ellen laughs as she chews up her noodles and spits them into a napkin, sat opposite a boy who seemingly finds it charming. In reality, chewing and spitting is mortifying for sufferers – it is the most private, personal, and isolating pain.

I can’t speak to whether To The Bone’s portrayal of in-patient facilities is realistic – but nor can many anorexia sufferers. It was nice that the film showed a variety of different body shapes in its hospice, illustrating eating disorders don’t discriminate. But for Britons, the NHS won’t take you in until you are the worst of the worst – Ellen herself. The reality for many anorexia sufferers is vastly different – and yes, it would make a terrible film. A dull, painful, and embarrassing film. But that doesn’t mean it shouldn’t be made.

Beat is a charity supporting those affected by eating disorders and campaigning on their behalf.

The Beat Adult Helpline is open to anyone over 18: 0808 801 067The Beat Youthline is open to anyone under 18: 0808 801 0711

As doctors and psychiatrists, we have seen the devastating effects of benefit reform on our patients

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